In 2016, our book Always Hungry? introduced a three-phase weight loss program based on a radical idea:
Overeating doesn’t make you gain weight—the process of gaining weight makes you overeat.
In other words, hunger and overeating are symptoms of an underlying problem. Although this idea may sound counterintuitive, it’s supported by a century of research that shows body weight is controlled more by biology than willpower over the long term. It means that your weight problem isn’t your fault. And it means you can solve your weight problem with a satisfying, delicious diet and a sustainable lifestyle plan!
You’ve heard it a thousand times: “All calories are alike.” To lose weight, just eat less and move more. It sounds so simple, anyone should be able to do it. But there are a few problems with this calories in, calories out approach to weight control.
First, it doesn’t work, not for most people over the long term. Sure, you can lose weight for a short while, but after a few weeks or months, the weight usually comes racing right back. Researchers analyzed low-calorie diet studies published in the New England Journal of Medicine and JAMA, two of the world’s most prestigious medical journals.1 Overall, participants in these studies lost a maximum of just 10 pounds—a small portion of their excess weight—and most regained much of the weight after one year. How many times has this happened to you?
How about exercise? Although physical activity has many important benefits, for most people, weight loss isn’t one of them. Scientific studies have consistently concluded that exercise by itself is not effective as a treatment for obesity.
Sadly, fewer than 1 in 5 people with excessive weight in the United States has ever lost just 10 percent of their weight and kept it off for just one year using standard approaches to diet and exercise.2 And this finding, based on self-reported data, is likely to be overstated, as many people tend to think they’re a little taller and a little lighter than they really are.
The second problem with the calories in, calories out approach is that it’s actually impossible to do in real life. Even nutrition experts can’t accurately determine their energy balance to within 300 calories a day—just one extra muffin. A daily excess of that magnitude would cause massive weight gain. For that matter, if calorie counting were critical to weight control, how did humans ever maintain a healthy body weight before the very notion of the calorie was invented?
And the third problem with calories in, calories out is that it implicitly blames overweight people. If losing weight is simply a matter of eating less and moving more, then everyone with excess weight must lack discipline, self-respect, or even proper values. This way of thinking explains why you might be blamed for being overweight in ways that would never occur with other medical problems. In a thousand ways, our culture says, “It’s your fault you’re fat.” Unfortunately, many people have internalized these beliefs. One survey found that a substantial proportion of adults would rather be infertile or die ten years earlier than be obese.3 And these attitudes begin very early in life, as demonstrated by one famous study. When children were shown images of other kids with various ailments—including one in a wheelchair, one on crutches, one with a facial disfigurement, one with no left hand, and one with obesity—they chose the heavy child for a friend last.4
Though pervasive, weight prejudice simply isn’t justified. Studies show that people with obesity aren’t any different from the general population when it comes to personal characteristics like discipline, values, and morals.5
In fact, the calories in, calories out approach fails not for lack of effort or willpower, but because it ignores the biological systems that control body weight.
When you cut back calories, of course you’ll lose weight—it’s a basic law of physics. But the body fights back, with rising hunger, slowing metabolism, and release of stress hormones that break down lean tissue. That’s the starvation response, and it primes your body to regain weight.
Think about it. People overeat mainly because of hunger. What happens when you eat less? You get even hungrier! Are you supposed to spend the rest of your life feeling that way? And even if you could, your body has other tricks, like slowing down your metabolism. This is a battle very few of us can ultimately win.
It’s like trying to treat a fever with an ice bath. Sure, you can force body temperature down for a short while, but your body would fight back, with severe shivering and blood vessel constriction—and you’d feel miserable. Treat the cause of the fever, and your body temperature decreases naturally. Treat the cause of obesity, and your weight decreases with your body’s cooperation, not with your body kicking and screaming.
What is the cause of obesity? As we’ll explore in chapter 2, the primary problem is fat cells stuck in calorie-storage overdrive. The low-fat, carbohydrate-laden diet we’ve been told to eat for forty years has raised levels of the hormone insulin, triggering our fat cells to hoard too many calories. Consequently, there are too few calories circulating in the bloodstream to satisfy the needs of the brain and the rest of the body. That’s why we get hungry, our metabolism slows down, and we gain weight. Cutting back on calories only makes this situation worse—creating a battle between mind and metabolism we’re destined to lose.
The solution is a diet and lifestyle plan that lowers insulin levels and calms chronic inflammation (insulin’s twin troublemaker). As insulin levels drop, fat cells settle down and release their excess calories back into the body. When that happens, hunger decreases, cravings vanish, metabolism speeds up, and you lose weight without the struggle. This marks the transition from the Always Hungry Vicious Cycle of weight gain to the Always Delicious Victorious Cycle of weight control (see the Figures in chapter 2, here and here).
The quickest, easiest, and most delicious way to lower insulin levels is to substitute luscious high-fat foods for all those processed carbohydrates that invaded our diet during the low-fat craze. Since this approach works with your body, not against it, you’ll eat until satisfied, snack when hungry, and never count calories again. (For further explanation of the program, see Always Hungry?)
You’ll enjoy nuts and nut butters, full-fat dairy, rich sauces and spreads, savory proteins (with vegetarian alternatives), and real dark chocolate. But this isn’t an Atkins-type very-low-carbohydrate diet either—you can have a range of natural carbohydrates.
Phase 1: Jump-start weight loss. For just weeks, you’ll give up grain products, potatoes, and added sugar. But with these luscious high-fat foods, you won’t crave the processed carbs at all. (Approximately 50 percent fat, 25 percent protein, and 25 percent carbohydrate.)
Phase 2: Reach your new body weight “set point.” You can add back whole-kernel grains, like steel-cut oats, brown rice, buckwheat, millet, and quinoa. You can also include nonstarchy vegetables like yam, sweet potato, and squash—just no white potato for now. You can even have a touch of added sugar. You’ll stay in this phase as you lose weight, until reaching a stable plateau—your new lower body weight set point. For people with relatively little weight to lose, that may take just a few weeks or months; for others, many months. (Approximately 40 percent fat, 25 percent protein, and 35 percent carbohydrate.)
Phase 3: Design your personalized prescription for life. You can mindfully add back modest amounts of more processed carbohydrates, according to your body’s ability to handle them, creating an individualized plan that’s right for you. (Approximately 40 percent fat, 20 percent protein, and 40 percent carbohydrate.)
In addition, the program includes three “Life Supports”—quality sleep, stress relief, and enjoyable physical activities. These important practices work with diet to help fat cells calm down and release their stored calories back into the body. We especially recommend a daily passeggiata—the Italian word for a relaxing walk after dinner. The goal isn’t to burn off a lot of calories. Instead, the passeggiata provides an enjoyable opportunity to improve metabolism and control blood sugar, while preparing your body for a restorative night’s sleep (see Always Hungry?).
Even the best possible diet will miss the mark if people don’t feel motivated and empowered to follow it. We live in what has been termed a “toxic environment,” surrounded by cheap junk foods and other harmful influences. For many of us, resisting these ubiquitous temptations and finding more healthful alternatives takes support—and that’s the power of community.
Prompted by our readers, we formed the Official Always Hungry? Book Community on Facebook in early 2016. Our goal was to provide a noncommercial and nonjudgmental space for people to ask questions, receive support, and travel together along the path of healing and wellness. With guidance from several dozen phenomenal volunteer moderators, the community has now grown to more than ten thousand members and counting. Since then, we’ve been honored to follow the experiences of readers as they’ve struggled with almost every imaginable health problem, encountered obstacles, and achieved success. (You’ll find the authentic stories of community members throughout this book.)
Since Always Hungry?—called “AH” in our Facebook group—is a “diet book,” many people were initially focused on losing weight, but the group evolved into much more. Without calorie restriction, weight loss may not be a sensational 30 pounds in 30 days. But without hunger and deprivation, it’s more sustainable.
For example, Charlotte A., age 52, from Charlotte, North Carolina, posted: “Sometimes people who have a lot of weight to lose look longingly at stomach surgery as the quick solution. I understand that. Last year, a friend and I who both work in healthcare were at a similar crossroads with our weight. The week I started AH, she had a vertical sleeve gastrectomy. Initially, she lost weight more quickly. But to date, she’s down 50 pounds, and I’m down 60 pounds—and 8 inches from my natural waist. Weight loss on this program may not be fast, but it’s steady and requires no anesthesia!”
Regardless of weight loss, members often relate “non-scale victories” (NSVs)—our term for benefits beyond weight loss involving physical, emotional, or mental health. Reports of diabetes resolution, better blood pressure, lower cholesterol, less “brain fog,” and improvement in chronic inflammatory conditions emphasize how powerful the combination of diet and community can be.
Billy W., age 35, from Clarksville, Tennessee, wrote: “Last November, I went to the doctor with frequent urination and excessive thirst. They discovered my hemoglobin A1c was 11.0 percent and my blood sugar was over 500! My doctor recommended Always Hungry? and I started the next week. Now, less than 4 months later, my Hemoglobin A1c level is down to 6.6 percent and blood sugar is averaging 109 to 117—without insulin! My blood pressure went from 150/90 to 115/70. I have energy I’ve never had, and I’m the happiest I have ever been. This program is helping save my life!”
Jennifer H., age 52, of Easton, Pennsylvania, posted: “My biggest NSV was totally unexpected: almost complete cessation of gastroesophageal reflux disease. I have a large hiatal hernia, for which I’d been taking proton pump inhibitors for more than a decade. Even with the treatment, I’d still wake up vomiting at least two nights a week. The doctors had recommended surgery, which I was putting off. Within a few months on AH, I realized I was no longer waking up at night. In consultation with my doctor, I was able to wean myself from the medication altogether. My quality of life has increased tremendously.”
And Amy T., age 43, of Toronto, Canada, reported: “I have endometriosis (among other things), and usually mid-month I have a few days of unrelenting pain. Then, right before my time, I break out like crazy. Since starting AH, the mid-month issues have really quieted down and my skin is amazing.”
Some of the most inspiring stories from our community chronicle an evolving relationship with food and triumph over addictive tendencies. As fat cells calm down and the body enjoys a more stable food supply, people often feel less obsessed with eating, more in control, and a natural desire for more nourishing foods.
Annette C., age 51, from Livingston, Scotland, wrote: “I’ve been reading posts in this group for a while, and I’m glad to say it’s a really supportive and safe place to talk about our weight loss and health journeys. Because of this, I wanted to share my biggest NSV. I had a very traumatic and difficult childhood and upbringing. I resorted to ‘comfort eating’ and started to gain weight from the age of nineteen. I’d punished myself by eating until I felt sick—sort of like bulimia without throwing up. I had some success in structured weight loss programs, but they never fully rid me of my compulsion. I started to feel different on AH around day three; my husband was working and I was on my own at night, a common trigger for extreme overeating. But this time I was able to ask myself, ‘Are you really hungry?’ and the answer was no! By the end of the fortnight I realized that I had had no bingeing episodes. Although I had assumed that my eating compulsion was emotional, it had actually been driven by cravings due to my low-fat, high-carb diet. I likened it to radio interference. As I eradicated the white noise of cravings, I was able to genuinely hear what my body was saying. For the first time in my life I feel normal. This isn’t a diet or an eating plan: If I never lost another pound or inch, it wouldn’t matter. I have gained so much more.”
And Trish M., age 42, from Vancouver, Washington, said: “For much of my life, I experienced hunger as a stress and could barely cope. I feared that if I didn’t eat, I would lose my usually cool head. When out running errands, even just ten minutes away from home, I’d feel compelled to stop for fast food if I got hungry… and I was always hungry! Now I’ve realized that ‘hunger’ was really a powerful addiction to sugar and grains. With AH, I notice my hunger and rationally think that it’s time to go home and make something to eat. This is huge for me! The palate adjustment has allowed me to enjoy fruits and berries more, and all the sweetness in natural foods. With every new recipe, I joyfully think, ‘Yep, I’m not suffering. This is SO GOOD!’ There is satisfaction in knowing that this food will help keep me healthy and active so that I can pursue my life goals. This life is so brief and I want to wring as much enjoyment out of it as possible.”
We’ve also seen frequent reports of improved energy level and physical fitness.
Kim G., age 28, from Davie, Florida, announced: “Huge NSV today! I am a freelance musician and work late hours that mess up my schedule. When I have to teach early, I roll out of bed and barely make it where I need to be. This morning, not only did I wake up early without trouble, I had time for my morning routine and a proper breakfast. AND after teaching four hours in a row, I miraculously did not feel remotely in need of a nap, which would’ve been guaranteed before. One of the greatest benefits of AH has been my increased energy levels, and the consistency of that energy. My stress levels seem way down. I’m able to get to sleep easier, stay asleep, and wake up without feeling like death warmed over. The weight loss is great, too, but I have to say, this is the big one for me!!”
And Sandy H., age 51, of Jefferson City, Missouri, wrote: “Yesterday I took a half-mile hike through the woods and up a hill. That may not seem like much, but a month ago, even thinking about doing that would have worn me out. Although I have lost 18 pounds on AH, there’s still a long way to go, so hauling my 300-plus-pound body up a hill is quite a big deal for me. It was beautiful up there!”
Others, like Paula T., age 61, of Sully, Iowa, experienced relief from anxiety or depression and a sense of internal peace: “AH has set me free! Free… from counting calories, from constant gnawing hunger, from weakness and fatigue, from fearing food. It’s been about forty-two years since I’ve known this kind of freedom and joy! Another benefit of this way of eating is a new calmness. My anxiety levels are practically nonexistent these days. I’m not afraid to eat anymore!”
We’ve also been privileged to extend our community outside the United States, including through a collaboration with the Centre for Hospitality and Culinary Arts at George Brown College (GBC), the largest culinary school in Canada. Working with the GBC Culinary Management Nutrition faculty, we helped create a recipe development course based on Always Hungry? guidelines. The first class of eighty students produced an amazing variety of delicious Phase 1 and 2 recipes for their final projects—you’ll find several of these featured in this book (and more on our blog, www.drdavidludwig.com). To change the food culture, we need a new generation of chefs with a vision for truly health-supportive cuisine.
Ultimately, the power to affect fundamental social change rests with community. After healing ourselves and our families, we can join together to help make the world a healthier place for everyone. In addition to the human toll, diseases of poor nutrition affect us all, through higher insurance costs, increasing Medicare spending, and the massive drag on our economy from lost productivity. Together, we can help create a society in which healthful foods and lifestyle choices are also convenient and affordable (see the Epilogue of Always Hungry? for our ten-point plan to make healthy food a national priority). Especially for the sake of our children, we must ensure that public health takes precedence over special interest and the short-term profits of the food industry.
One of the most frequent requests in our Facebook community is for new recipes… and you’ll find more than 175, ranging from appetizers to desserts, in chapters 4 through 12—each adapted to all three program phases. In addition, many members have described overcoming a lifelong fear of the kitchen as they discovered the joys and rewards of home cooking. In chapter 3, Chef Dawn shares her secrets for how anyone can become a confident, competent home chef the Always Delicious way.
But first, we’ll explode the forty-year low-fat diet myth that has caused so much suffering. Chapter 2 takes a deep dive into the fascinating science of hunger, cravings, food addiction, and taste. You’ll learn how a luscious higher-fat diet reprograms fat cells and taste buds, so that nutritious foods become delicious and junk foods lose their hold on us.
And as you get started, please keep our motto in mind:
Forget calories.
Focus on food quality.
And let your body do the rest!